Assessment. A process to gather the information necessary to make a diabetes self-management education and support (DSMES) plan with the participant. The DSMES assessment must be completed by a health care professional.

Assessment Tools.

• The Diabetes Distress Scale (DDS) (short form)

○ A two-question initial screening tool to assess diabetes-specific distress (followed by the full 17-item scale when indicated) (175)

• The WHO (Five) Well-Being Index

○ Validated in many languages, is a reliable measure of emotional functioning and screen for depression and has been used extensively in research and clinical care (176), including the DAWN2 study (Diabetes Attitudes, Wishes and Needs 2) (177)

○ An eight-item simplified food frequency instrument designed for use in primary care and health-promotion settings (184)

• Three-item screen

○ A tool to measure health literacy. It asks how often someone needs help reading hospital materials, how confident they are filling out forms, and how often they have difficulty understanding their medical condition (185)

Behavioral goal setting. The practice of identifying health behaviors to modify, setting a target to reach, and planning a course to achieve the target.

Capacity. The ability a person has to understand and manage their condition.

Cognitive computing. The simulation of human thought processes in a computerized model to mimic the way the human brain works.

Data mining. The ability of a coordinator to aggregate data from within their organization’s documentation system.

Diabetes paraprofessional. A person with a nonmedical background who can provide support as a part of a diabetes care team.

Diabetes professional. A person with a medical background who is part of a diabetes care team.

Diabetes self-management education and support (DSMES). The ongoing process of facilitating the knowledge, skills, and ability necessary for prediabetes and diabetes self-care, and the activities that assist the person with diabetes or prediabetes in implementing and sustaining the behaviors needed to manage his or her condition on an ongoing basis beyond or outside of formal self-management training. This process incorporates the needs, goals, and life experiences of the person with diabetes or prediabetes and is guided by evidence-based standards. Support (whether behavioral, educational, psychosocial, or clinical) helps implement informed decision making, self-care behaviors, problem solving, and active collaboration with the health care team and to improve clinical outcomes, health status, and quality of life.

Disease burden. The impact a disease has on the various components of a participant’s life, such as physical, financial, or mental aspects.

Electronic health records (EHR). The digital version of a patient’s chart. EHR are available in real time and available to patients and their care team immediately.

Goals. The desired results for DSMES, set by those receiving DSMES services and their care teams.

Health care stakeholder. Anyone involved in or affected by the financing, implementation, or outcome of a service, practice, process, or decision made by another (e.g., health care, health policy). Examples of stakeholders with interest in health care are providers, patients (health care consumers), payers, etc.

Mission. Core purpose, direction, and why the organization exists. It describes who it serves and how it does it.

National Diabetes Prevention Program (National DPP). An evidence-based intervention that allows purchasers, payers, and providers to prevent or delay onset of type 2 diabetes in patients with prediabetes or at high risk for type 2 diabetes. The intervention is founded on the science of the Diabetes Prevention Program research study and several translation studies. These studies showed that making modest behavior changes helped participants lose 5 to 7% of their body weight and reduced the risk of developing type 2 diabetes by 58% in adults with prediabetes (71% for people over 60 years of age). The National DPP lifestyle change program is a year-long structured program (in-person group, online, or combination) consisting of:

• an initial six-month phase offering at least 16 sessions over 16–24 weeks and a second six-month phase offering at least one session a month (at least six sessions)

• facilitation by a trained lifestyle coach

• use of a CDC-approved curriculum

• regular opportunities for direct interaction between the lifestyle coach and participants

• focus on behavior modification, managing stress, and peer support

The CDC Diabetes Prevention Recognition Program assures that organizations can deliver the lifestyle change program effectively and achieve the outcomes necessary to prevent or delay the onset of type 2 diabetes. To achieve CDC recognition, organizations must use a CDC-approved curriculum and meet national quality standards.

Person-centered care practice. Efforts to recognize the people using health services as equal members of the care team in planning, executing, and monitoring their care and keeping their needs at the forefront.

Prediabetes. Blood glucose levels that are higher than normal but not high enough to be diagnosed as diabetes.

Service. A system or actions dedicated to supplying a demand.

Social determinants. The conditions in which someone lives, learns, works, and ages that affect their health.